New initiative to speed development and introduction of vaccines to protect against cervical cancer

13 June 2005 | Salvador da Bahia, Brazil -The World Health Organization (WHO) has received a grant of US$ 7 million from the Bill & Melinda Gates Foundation, as part of an integrated effort to accelerate the development and introduction of human papillomavirus (HPV) vaccines to protect against cervical cancer.

The announcement was made today in Salvador da Bahia, Brazil, during the sixth annual WHO Global Vaccine Research Forum which brings together top vaccine scientists, researchers and public health experts to discuss new vaccines and vaccination policy.

The grant to WHO is part of a joint international effort with the International Agency for Research on Cancer (IARC), Harvard University and the Program for Appropriate Technology in Health (PATH), which have also received new grants from the Bill & Melinda Gates Foundation. The four grants announced today total US$ 12.9 million.

"I am very pleased to accept this contribution. It will help to save the lives of many women by immunizing them against human papillomavirus infections," said Dr LEE Jong-wook, Director-General, WHO.

HPVs are the most common sexually transmitted viruses worldwide and infect about 70% of sexually active adult populations. While HPV infection clears without treatment in the majority of people, it can develop into chronic infection and, in some women, causes cervical cancer. HPV infections are associated with more than 99% of all cervical cancer cases worldwide.

Cervical cancer is the leading cause of death from cancer among women in developing countries, killing about a quarter of a million women a year. The disease affects about half a million women every year, and represents a major health inequity, as 80 % of cervical cancer victims live in low- or middle-income countries.

Currently, the best way to prevent cervical cancer is through regular gynaecological screening and, when necessary, treatment of associated pre-cancerous lesions. However, due to the cost and complexity of regular screening and treatment, this method has had only a limited impact in the countries where it is most needed.

Vaccines to prevent HPV infections have the potential to be cost-effective and to reduce the incidence of cervical cancer and related pre-cancerous lesions, particularly in low-resource settings. Modelling studies suggest that combining HPV vaccination and screening programmes may have the most impact on disease control.

Two candidate HPV vaccines, both protecting against the most common cancer-causing HPV types (HPV 16 and 18), and one also protecting against genital warts (including HPV 6 and 11 in addition to HPV 16 and 18), are in Phase III clinical trials and should be available in the near future. Encouraging results from Phase II trials have shown that these vaccines can protect against HPV infections with the above types and associated pre-cancerous lesions in previously uninfected young women.

With two promising HPV candidate vaccines on the horizon, there are complex challenges ahead that must be overcome before the vaccine can be successfully introduced in developing countries. A broad strategy to address these challenges aims to support additional studies which are needed in key high disease burden areas.

The Gates Foundation grants announced today will support the following projects:

The WHO Initiative for Vaccine Research will work with partners to create an HPV Laboratory Network to facilitate vaccine licensing and monitoring in developing countries and to harmonize and standardize laboratory procedures; create an international multi-disciplinary policy platform and set guidelines for future HPV vaccine introduction, in consultation with regions and countries; and to create a WHO Information Centre on HPV and Cervical Cancer to facilitate global, regional and country specific decisions on current and new options for cervical cancer prevention.

The International Agency for Research on Cancer (IARC) will collect new epidemiological data on HPV in low-resource countries in Asia, Africa, and Eastern Europe.

Harvard University will develop a series of models for different epidemiologic settings that will be used to evaluate both the population impact and cost-effectiveness of different HPV vaccination strategies.

The Program for Appropriate Technology in Health (PATH) will work to develop partnerships with the private sector to facilitate early introduction of HPV vaccine in selected developing countries, develop a case for investing in HPV vaccine, address country- and region-specific programmatic issues, and identify information needs.